Monday, August 23, 2010

Reimbursement Continues to Be an Issue in Weight Loss and Weight Management

Insurance companies are more likely to reimburse weight loss surgery providers than non-surgery weight loss providers. And there is a reason for this difference in reimbursement practices: There is less of a proven payback for non-surgical weight loss protocols than for surgical weight loss protocols.

Indeed, researchers in France reported that "Bariatric surgery was associated with significant reductions in reported claims for short- and long-term health outcomes and reduced medication use for major disease categories." So reimbursing a bariatric surgical provider seems cost effective.

However, there may be hope for non-surgical weight loss and weight management treatment reimbursement. A 2007 study done at the University of Kentucky, Departments of Pediatrics suggested that there were improvements in the reimbursement rates associated with non-surgical weight loss treatment -- at least for children.

In fact, the researchers carrying out the study stated that while "preventive counseling [for weight management] has not been routinely reimbursed very well by third-party payors," there was "improved reimbursement rates for the evaluation and management of overweight children."

But still, it is apparent that the reimbursement level for non-surgical weight loss and weight management is not what it should be -- even for children. A docu-drama , entitled “Too Fat for Fifteen: Fight Back" aired on the Style network, suggests that insurance reimbursement for non surgical weight loss treatment is lacking, when it comes to treatment for childhood obesity.

One of the parents of a teen highlighted in the docu-drama stressed that “We want the insurance industry to provide some reimbursement for families.” The parent went on to say that “It’s better to make an investment in the child now than wait until their 20s and 30s when they have issues like cardiovascular disease and they need medications.”

But one of the reasons insurance companies are reluctant to reimburse non-surgical weight loss or weight management treatments is the dearth of proven non-surgical weight management protocols. However, ongoing exercise and dietary counseling, and other interventions, can lead to weight loss and weight management success. One of the students depicted in the docu-drama, so far, has lost over 51 pounds. This type of success will lead to improved reimbursement.

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Thursday, August 5, 2010

Sleeve Gastrectomy May Have an Important Side Effect

Sleeve gastrectomy is a form of bariatric surgery where a small "banana like" stomach pouch is created to restrict food intake. The surgery is commonly one stage of a two stage bariatric surgical procedure. The second stage, for example, might be gastric bypass surgery. But a retrospective study, done by a group with The Bariatric Institute of Cleveland Clinic, Florida, concluded that laparoscopic sleeve gastrectomy (LSG) is a safe single-stage primary procedure. However, there does now appear to be reasons to be cautious about the surgery.

It has been known for sometime that some forms of bariatric surgery, including gastric bypass surgery, can increase the alcohol absorption rate. Some people who have bypass surgery experience the effects of alcohol quicker and longer than they did before the surgery, according a 2007 study done by John M. Morton, MD, of Standford University. That's why persons who have undergone gastric bypass surgery are urged to "keep an eye on alcohol intake." Indeed, 'one drink could be enough to place them at risk for a DUI,' according to Morton.

And a recent study confirms that, like gastric bypass surgery, LSG causes increased alcohol absorption. The study, done in Chile, studied twelve obese patients. The patients were given specific quantities of wine before and after LSG surgery. Researchers followed the twelve study participants for several months. At the end of the study period, the researchers concluded that the participants experienced "higher and longer blood alcohol values for equivalent amounts of alcohol."

Still, bariatric surgery is one of the most effective tools in the fight against obesity. Bariatric surgery leads to more instances of long term weight loss than other weight loss methods. And as we stated earlier, LSG can be a single-stage primary procedure, in addition to one stage of a two-stage bariatric procedure.

Finally, while laparoscopic sleeve gastrectomy may be an important surgical offering for those bariatric centers offering other forms of bariatric surgery, patients should be informed of the possible increased alcohol absorption. But even with this side effect, offering LSG could give a weight loss or bariatric center a competitive advantage.

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